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NPI 1922112119

NPI 1922112119 : JAMES R BOLLINGER, MD PC : PAOLI, PA

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General NPI Number Information
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    NPI Number           |    1922112119
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    Entity Type          |    Organization 
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    Legal Business Name  |    JAMES R BOLLINGER, MD PC 
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Dates
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    Enumeration Date     |    08/18/2006
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    Last Update Date     |    05/11/2015
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Provider Practice Location Address
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    Address Line         |    209 W LANCASTER AVE SUITE 200
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    City                 |    PAOLI
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    State                |    PA
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    Zip                  |    19301-1749
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    Country              |    US
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    Telephone            |    610-296-0810
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    Fax                  |    610-296-4968
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Provider Business Mailing Address
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    Address Line         |    209 W LANCASTER AVE SUITE 200
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    City                 |    PAOLI
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    State                |    PA
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    Zip                  |    19301-1749
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    Country              |    US
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    Telephone            |    610-296-0810
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    Fax                  |    610-296-4968
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     JAMES RICHARD BOLLINGER 
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    Credential           |    MD
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    Telephone            |    610-296-0810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208800000X
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    Taxonomy Name        |    Urology Physician
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    License Number       |    MD014743E
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    License Number State |    PA
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